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BLOOD AND BLOOD FORMING ORGANS › BLOOD SUBSTITUTES AND PERFUSION SOLUTIONS › IRRIGATING SOLUTIONS › Salt solutions
sodium chloride
B05CB01
Forms & Strengths
- Intravenous Solution: 0.45% (half-normal), 0.9% (normal), 3%, 5%
- Irrigation Solution: 0.9%
- Ophthalmic Ointment: 5%
- Ophthalmic Solution: 2%, 5%
- Nasal Spray/Drops: 0.65%, 0.9%
- Tablet: 1g
Adult Dosing
- Isotonic dehydration/maintenance (0.9% IV): 1-2 L daily as clinically indicated
- Severe hyponatremia/increased ICP (3% IV): 100-250 mL infused over several hours with frequent serum sodium monitoring
- Hypotonic dehydration (0.45% IV): Infuse based on deficit calculations, not to exceed 100 mEq/hour
- Nasal congestion: 1-2 sprays per nostril PRN
- Ophthalmic edema: 1-2 drops every 3-4 hours or ointment at bedtime
Pediatric Dosing
- Maintenance IV fluids (0.225% to 0.9% with dextrose): Calculated via Holliday-Segar method (100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day thereafter)
- Symptomatic hyponatremia (3% IV): 3-5 mL/kg infused over 30-60 minutes
- Nasal congestion: 1-2 drops per nostril PRN
Indications
- Treatment and prevention of sodium and chloride depletion
- Extracellular fluid replacement and maintenance
- Diluent for compatible IV medications
- Reduction of corneal edema
- Nasal mucosal lubrication and relief of congestion
Mechanism of Action
- Sodium is the primary extracellular cation regulating extracellular fluid volume, plasma osmolality, and acid-base balance
- Chloride is the major extracellular anion complementing sodium to maintain ionic equilibrium and osmotic pressure
Contraindications
- Hypernatremia
- Fluid retention or hypervolemia where administration could worsen clinical condition
- Hyperchloremia
Adverse Reactions
- Hypernatremia
- Hyperchloremic metabolic acidosis (with large volumes of 0.9%)
- Fluid overload, pulmonary edema, peripheral edema
- Injection site reactions, phlebitis, or extravasation necrosis (hypertonic solutions)
- Transient stinging or irritation (ophthalmic/nasal use)
Drug Interactions
- Corticosteroids: May cause sodium and water retention with concurrent edema
- Lithium: Renal clearance of lithium may be increased during sodium loading, decreasing lithium efficacy
- Vasopressin or oxytocin: Increased risk of acute hyponatremia and water intoxication
Curated Content: Needs Vetting Before Put to Clinical Use